Preterm Birth Among Black Latina Women in the United States: The Impact of Self-Identified Race

BACKGROUND The Latinx population is the second largest and fastest-growing ethnic group in the U.S. A significant percentage of Latina women self-identify as Black, but the influence of race on specific subtypes of preterm birth (PTB, <37 weeks), and whether this relationship varies by maternal nativity, remains unclear. OBJECTIVE To assess whether self-identified Black race is associated with increased risk of PTB subtypes among U.S.-born and foreign-born Latina women. METHODS We analyzed 2018-2020 National Center for Health Statistics vital records using stratified and multivariable binomial log-linear regression. The study included singleton live births to Latina women who self-identified as Black or White. RESULTS Among U.S.-born Latina women (N=42,051), the overall PTB rate was 12.6% for Black women and 11.1% for White women. Among foreign-born Latina women (N=17,165), PTB rates were 11.6% vs. 11.1% for Black and White women, respectively. Rates of extremely (<32 weeks) and moderately (32–34 weeks) preterm birth were higher for Black than White women in both nativity subgroups, while late PTB (34–36 weeks) rates were similar. Adjusted relative risks (RR, 95% CI) for extremely, moderately, and late PTB among U.S.-born Black vs. White Latina women were 1.44 (1.34–1.55), 1.17 (1.10–1.23), and 1.06 (1.02–1.10). Among foreign-born Black vs. White Latina women, adjusted RRs were 1.26 (1.23–1.42), 1.04 (0.95–1.14), and 1.01 (0.95–1.07). CONCLUSIONS Black race modestly increases the risk of extremely early PTB for both U.S.-born and foreign-born Latina women. These findings suggest that structural and contextual factors linked to race negatively impact birth outcomes among Latina women.